• Weiping Cao, Tingmei Chen, Wen Jiang, Yinping Geng, Bing Xie, Qin Wang, and Xinzhi Wang.
• Departments of Obstetrics, Maternity and Child Health Hospital of Zhenjiang, Zhenjiang, Jiangsu, PR China.
• Medicine (Baltimore). 2022 Feb 4; 101 (5): e28723e28723.

RationaleAcute fatty liver of pregnancy (AFLP) is a rare and potentially fatal complication that occurs in the third trimester or early postpartum period. The diagnosis of AFLP is based on typical clinical and laboratory features and imaging examinations.Patient ConcernsCase 1: a 25-year-old pregnant woman was hospitalized for threatened preterm birth at gestation of 35weeks and 2 days gestation. Laboratory tests revealed liver dysfunction, coagulopathy, hypoglycemia, hypoproteinemia, leukocytosis, and elevated creatinine and uric acid levels. Case 2: a 28-year-old (nulliparous) became pregnant after in vitro fertilization-embryo transfer at 29 weeks and 1 days' gestation and came to the obstetric ward for vaginal bleeding. At 34 weeks and 1 day, laboratory investigations showed high serum creatinine, uric acid, liver dysfunction, coagulopathy, and hypoglycemia.DiagnosesTwo patients did not show obvious clinical symptoms, while the ultrasound findings confirmed a diagnosis of AFLP.InterventionsImmediate delivery and comprehensive supportive treatment are the most important methods for the treatment of AFLP.OutcomesThe 2 patients and their babies were discharged from the hospital in a good condition.LessonsSpecial attention should be paid to mothers with AFLP after in vitro fertilization-embryo transfer. The clinical presentation of AFLP is variable, hence laboratory features and ultrasound examination may be important methods for screening for AFLP.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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